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From the 6/11/2021 release of VAERS data:

This is VAERS ID 237316



Case Details

VAERS ID: 237316 (history)  
Form: Version 1.0  
Age: 14.0  
Sex: Male  
Location: Nevada  
Vaccinated:2004-06-02
Onset:2004-06-16
   Days after vaccination:14
Submitted: 2005-05-12
   Days after onset:330
Entered: 2005-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER UNKNOWN / 3 RA / IM
HEPAB: HEP A + HEP B (TWINRIX) / GLAXOSMITHKLINE BIOLOGICALS UNKNOWN / 1 RA / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Abdominal pain, Asthenia, Colitis, Crohn's disease, Diarrhoea, Gastrointestinal disorder, Headache, Laboratory test abnormal, Nausea, Weight decreased
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal premalignant disorders (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific inflammation (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Noninfectious diarrhoea (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Doxycycline for Acne.
Current Illness: None
Preexisting Conditions: Acne. Information received from medical records states previous GI disease, dyspepsia. msv
Allergies:
Diagnostic Lab Data: Endoscopy. Upper and lower GI. Cat scan with IV. Blood work. X-rays, swallowing barium solution. Ultra-sound. Information from medical records states abnormal lab results. msv
CDC Split Type:

Write-up: Was diagnosed with Crohns disease by October 2004, after suffering with stomach problems since mid-June. Follow up on 7/12/05: Same as stated on initial report - Crohn''s Disease. Information from medical records state headache, asthenia, weight loss, nausea, diarrhea, colitis, abdominal pain. msv


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